Jiang Dailiang, Nie Lei, Xiang Xuying, Guo Xiaoqing, Qin Mengting, Wang Shengnan, Chen Jiaojiao, Feng Yuhang, Huang Ming, Mao Ling
Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Hubei University of Chinese Medicine, Wuhan, China.
Front Nutr. 2025 Mar 31;12:1510111. doi: 10.3389/fnut.2025.1510111. eCollection 2025.
Stroke is a leading cause of death and functional decline that places a significant burden on healthcare systems. Malnutrition is a critical clinical concern that complicates the condition of stroke patients and contributes to unfavorable outcomes. Dysphagia is the primary cause of malnutrition in the acute stage after stroke. Enteral nutrition (EN) has been employed to manage the nutritional status of stroke patients to prevent and treat malnutrition. Early EN (EEN) has been shown to reduce mortality and the prevalence of malnutrition while enhancing functional outcomes. In the majority of cases requiring nutritional support, nasogastric tube (NGT) placement is prioritized. However, under specific circumstances, direct enteral tube (DET) feeding that includes percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic jejunostomy (PEJ), offers distinct advantages, particularly for PEG. Compared to intermittent EN, continuous EN demonstrates better tolerance. An EN protocol providing sufficient nutrient supply and energy support can alleviate neurological deficits and reduce the severity of motor dysfunction in stroke patients, thereby improving their prognosis. Energy-rich formulations of EN and EEN may be associated with a lower incidence of stroke-associated pneumonia (SAP). However, the use of EN may lead to an increased incidence of digestive complications, and hyperglycemia. In this study, we reviewed the indications, opportunities, and management methods for EN application, along with the nutrient composition of nutritional protocols for stroke patients.
中风是导致死亡和功能衰退的主要原因，给医疗系统带来了沉重负担。营养不良是一个关键的临床问题，它使中风患者的病情复杂化，并导致不良后果。吞咽困难是中风后急性期营养不良的主要原因。肠内营养（EN）已被用于管理中风患者的营养状况，以预防和治疗营养不良。早期肠内营养（EEN）已被证明可以降低死亡率和营养不良的发生率，同时改善功能结局。在大多数需要营养支持的情况下，优先考虑放置鼻胃管（NGT）。然而，在特定情况下，包括经皮内镜下胃造口术（PEG）和经皮内镜下空肠造口术（PEJ）在内的直接肠内管饲（DET）具有明显优势，尤其是PEG。与间歇性肠内营养相比，连续性肠内营养耐受性更好。提供充足营养供应和能量支持的肠内营养方案可以减轻中风患者的神经功能缺损，降低运动功能障碍的严重程度，从而改善他们的预后。富含能量的肠内营养和早期肠内营养配方可能与较低的中风相关性肺炎（SAP）发病率相关。然而，使用肠内营养可能会导致消化并发症和高血糖的发生率增加。在本研究中，我们回顾了肠内营养应用的适应症、时机和管理方法，以及中风患者营养方案的营养成分。
